Healthcare Provider Details

I. General information

NPI: 1457676645
Provider Name (Legal Business Name): THERESA LEE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2010
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10103 RIDGEGATE PKWY STE 312
LONE TREE CO
80124-5525
US

IV. Provider business mailing address

10103 RIDGEGATE PKWY STE 312
LONE TREE CO
80124-5525
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-8888
  • Fax: 866-456-4594
Mailing address:
  • Phone: 303-788-8888
  • Fax: 866-456-4594

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number52288
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberDR0058215
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number25588
License Number StateCT
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: